What killed Wolfgang Amadeus Mozart at the age of 35?
German stamp marking 200th anniversary of Mozart's death.
Historians and medical experts have debated the question for nearly 218 years. A European group now has evidence the prodigious composer was the victim of a strep outbreak.
The researchers looked at causes of death in Vienna in the winter of 1791 -- Mozart died on December 5 of that year -- and during the same period in the adjacent years.
In the year of Mozart's death, there was a sudden spike in deaths from edema, or abnormal fluid buildup. At the time, about a quarter of the deaths in younger Viennese men were from this cause.
One thing known for sure about Mozart's terminal illness: It caused terrible swelling. According to his family, he couldn't even turn over in bed. Some have ascribed the swelling to heart failure from a childhood bout of rheumatic fever, which can damage heart valves.
But the new report, in the Annals of Internal Medicine, says the spike in edema deaths around the same time suggests an epidemic cause. The increase was especially high among soldiers, leading Richard H.C. Zegers of the University of Amsterdam and his colleagues to speculate that the outbreak started in a military hospital.
Streptococcal infection fits the picture, they say, because strep can inflame the delicate blood vessels in the kidney called glomeruli that filter wastes from the blood. Within 10 days or so of a strep throat or a strep skin infection, the kidneys can fail from this damage. Intense swelling, from buildup of fluid, is often the result.
Mozart's final illness lasted 15 days. That also fits the new hypothesis.
Bach Bonus: Zegers, an ophthalmologist, published another paper on a long-deceased composer back in 2005. In the Archives of Ophthalmology, Zegers wrote that Johann Sebastian Bach suffered from myopia and probably cataracts late in life. For more on Zegers' research into the medical histories of Bach and Mozart, see his Web site: Mozach.nl